Tennessee Medical Malpractice Law Blog

Here is a really interesting website of the University of Arkansas for Medical Sciences (UAMS) Department of Neurobiology and Developmental Sciences.  Here you can find multiple atlas images, including sectional and MRI images, of the brain and spinal cord. 

While reviewing a stroke victim's chart, you may run across something called the Hunt and Hess Stroke Scale.  This is one of the scales a provider may use to evaluate/grade the clinical condition of a patient following a subarachnoid hemorrhage.    Click here for a listing we found on the Internet Stroke Center website of the signs and symptoms associated with each grade of the scale.

Deep vein thrombosis (DVT) is a disorder involving the development of a clot in a deep vein in the body.  In orthopaedic patients, trauma (including fractures) and certain procedures such as total hip replacements and total knee replacements increase a patient's chances of developing a DVT.  Prophylactic measures for prevention of DVT are typically instituted in these type cases.  Here is some useful information regarding DVT and DVT prophylaxis from Wheeless' Textbook of Orthopaedics.

Carpal tunnel release surgery is a very common procedure.  Here is a video of the surgical procedure from the OR-Live Surgical Archives. 

Organizing a medical records chart in a manner in which you and your expert(s) can easily review the records and also quickly find key documents can be a difficult task.  We find it very helpful to organize a medical chart using medical record tab dividers.  You can purchase these tab dividers or you can create your own using blank tabs.  The categories we use are as follows:  Admission Records; History & Physical; Discharge Summary; Outpatient Records; Physician Orders; Lab Reports; Progress Notes; X-ray Reports; Rehab & Therapy; Medications; Nurses Notes; Records of Operation; Anesthetic Records; Consultations; and Miscellaneous.  It is also helpful to make sure you organize the records behind each tab in chronological order.   

We've all reviewed medical charts of patients who have had cardiac enzymes drawn.  These studies are frequently drawn when physicians are evaluating whether a patient has suffered a heart attack.  Here is a helpful explanation of cardiac enzymes that I ran across on the WebMD website.

In addition to medical providers evaluating the neurological status of intensive care unit patients using the Glasgow Coma Scale, you often see Richmond Agitation Sedation Scale (RASS) scores documented in the ICU flowsheets.  The RASS score helps to measure the sedation and agitation of ICU patients, and is often considered when titrating sedation medications, etc.  Here is an article regarding RASS scores which includes a table to help in understanding how medical providers come up with an RASS score for these patients.

Here is an online Merriam-Webster medical dictionary I found on the Medline Plus website.  Save this to your favorites, and you won't have to get up from your desk to locate a dictionary when you come across an unfamiliar medical term.

We have had cases in the past that involved surgery for congenital heart defects.  The heart anatomy and blood flow with these defects can be very difficult to understand.  Here is a University of Kansas Medical Center website I found that lists numerous congenital heart defects.  In addition to viewing normal heart diagrams next to diagrams of hearts with congenital abnormalities, you can view chest x-rays, echocardiograms, and electrocardiograms of patients with defects.   

We find it helpful to keep a book of medical illustrations in the office for quick reference.  The book we use most often is the Atlas of Human Anatomy by Frank H. Netter, M.D.  You can purchase the book at most medical school libraries or online.   

A study from the New England Journal of Medicine reported that hospitals delayed in performing angioplasties.

"Researchers from Yale School of Medicine identified several ways to speed up what they call the “door-to-balloon” time—the period between the patient’s arrival at the hospital and the moment blood flow is restored to the heart by opening a blocked artery with a catheter equipped with an inflatable balloon at the end," according to a summary of the article published in Khaleej Times Online. 

The summary of the article says that "[t]he study, which included 365 US hospitals, showed that the delay in performing angioplasty varied from between 55 and 120 minutes after arriving at the emergency room.  Federal recommendations are for less than 90 minutes. The risk of death rises 42 percent if the procedure is delayed at least 30 minutes, according to the researchers. "

You can find the original article, as well as several other articles about treatment of heart attacks, at www.nejm.com.

Check out this video of a coronary artery bypass procedure performed at Morristown Memorial Hospital in New Jersey.  We find these surgical videos fascinating.  They also help us to better understand the procedures and interpret operative reports.  

While researching information regarding spinal conditions, I ran across this helpful website where you can view animations to gain a better understanding of spinal conditions.  You can also view animations that describe some of the spinal surgery procedures and can access a video library of actual spinal surgeries.  Click here to view the website.

I recently came across a very informative website that provides detailed information regarding the care and treatment of burn patients, Burnsurgery.org. Here you can find educational modules regarding the initial management of burn patients, metabolism and nutrition of burn patients, pulmonary problems of burn patients, and various other aspects of caring for these patients. There are charts describing the degrees of burns along with algorithms, diagrams, and numerous photographs. I think you will find this website to be very helpful.

Check out this helpful website that describes ultrasound technique and explains why ultrasounds are performed during pregnancy.  Here it explains the different fetal measurements taken during an ultrasound and provides charts regarding the measurements.  It also lists some fetal malformations that can be diagnosed by ultrasound.

Visit this website to find out health care provider ratings on patient safety and  health care quality as judged by the Joint Commission on Heathcare Accreditation of HealthCare Organizations.

The Centers for Medicare & Medicaid Services has a website called Home Health Compare where you can compare Medicare-certified home health agencies.  Check it out here.

Here is another location where you can find links to healthcare provider licensure verification websites for each state.

Here is an article about foreign objects being retained in surgery patients.  The article is published by The Doctor's Company, a professional liability insurer for physicians.

An excerpt:  "From 1985 to 1998, the incidence of objects being left within surgical patients has occurred at a steady rate of more than 40 per year. Specifically, 601 such cases have involved hospitals, surgical clinics, and physicians insured by The Doctors Company during that time period. The incidents have encompassed all medical specialties, and the variety of retained foreign bodies has included 4x4 and laparotomy sponges, needles, hemostats, broken or dislodged pieces of equipment—even a towel." 

Those numbers must be just for that company.  We see more than one such case a year in our practice in Nashville.

Another excerpt, this time a shot at the other personnel in the OR: "It is acknowledged by medical professionals that the operating surgeon should not be responsible for maintaining an account of objects that are admitted to or removed from the operative field. That responsibility belongs to the medical facility where the procedure is performed and to its employees, the circulating and scrub nurse."   I wonder:  does that go for the towel, too? 

One last point.  The article goes on to explain that "[t]o help protect themselves from liability, prudent surgeons should adopt three preventive measures."  Note the mindset.  The surgeons should take these actions not to protect patients but to protect themselves.  Hmmm.

Check out this FDA website, Drugs @ FDA.    Here you can look up medications, see the label and approval history including all related documents, review label information, and read about important information from the FDA regarding the medications.  Additionally, there is a demo showing how to use the website.  This is another great website to bookmark. 

Research indicates that afternoon operations are more likely to lead to adverse events related to anesthesia. 

A study was recently published in Quality & Safety in Health Care.  A summary of the study  published at www.drkoop.com,  said that "researchers analyzed more than 90,000 surgeries performed at Duke Hospital from 2000 to 2004, and categorized them according to type or severity of the adverse event. The categories were then cross-referenced with the time of the surgery.  Adverse events were most common for operations starting between 3 p.m. and 4 p.m., as compared with 7 a.m. The lowest probability of having an adverse event (1 percent) was at 9 a.m. and the highest (4.2 percent) at 4 p.m."

Why is this so?  " 'Patients might be more susceptible to pain in the afternoon,' [study author Dr. Melanie] Wright said.

The late-afternoon period also coincides with natural lows in the circadian rhythm, or the body's internal clock. Anesthesia care teams usually change at about 7 in the morning, and again between 4 p.m. and 6 p.m. This could be colliding with circadian low points and end-of-day fatigue.

A new concept called "chronobiology" might even be at fault. 'It is possible that people react to drugs differently at different times of the day,' said Dr. David Birnbach, director of the University of Miami's Center for Patient Safety. 'People are now looking at the effect on drugs of circadian rhythms, how long since the last cup of coffee, how many visitors, was it a quiet time or busy time,' he added.

There may also be less focus in the afternoon, as people take on more and more tasks, Lubarsky, who was working at Duke while the study was ongoing, pointed out. 'People get distracted trying to relieve colleagues, and the number of cases does indeed go up. Late afternoon meetings occasionally occur and pull you away,' he said. "

Read the entire article here.

Another website to check for Medical Information is www. healthfinder.gov which is provided by the U.S. Departmetn of Health and Human Services.

The Brain Trauma Foundation has developed treatment guidelines. Check out the website and view their guidelines online concerning prehospital management of traumatic brain injury, management and prognosis of severe traumatic brain injury, surgical management of traumatic brain injury, and acute medical management of severe traumatic brain injury in infants, children, and adolescents.

For information on a multitude of medical conditions, including photographs and links to other resources, check out Hardin.MD by the University of Iowa.

Check out The American Hospital Directory website. Here you can find information regarding hospitals, including the type of facility, number of beds, types of clinical services offered, state statistics, etc. You can easily locate hospitals in a specific area and links to the hospitals' websites.

I love these. Here is a "how to" on arterial line placement.

The Joint Commission has released the Fourth Edition of its book "Patient Safety Essentials for Health Care."

The blurb: "This book is the complete guide to the Joint Commission's safety standards for ambulatory care, behavioral health care, critical access hospital, home care, hospital, and long term care organizations. It includes the standards, rationales, elements of performance, and scoring information in one handy resource. This book also identifies the commonalities among the standards to help readers understand which standards apply to which settings."

Order it for $75.00 here.

This video from the New England Journal of Medicine explains how to insert a nasogastric tube. It also explains the indications and contraindictions for the procedure.

This video from the New England Journal of Medicine explains how to perform a urethral catherization on a male. It explains the anatomy, describes the indications and contraindications for the procedure, and reviews the equipment necessary for the procedure.

Note: you have to register to see video, but you can do so at no charge.

There is an online digital library, Anatomy Atlases, that includes information regarding anatomy such as illustrations in an atlas of human anatomy and an atlas that includes cross-sections. Another interesting thing included in this site is a section on microscopic anatomy. This is a good site to bookmark for quick anatomy reference.

If you've ever had difficulty during a medical chart review in determining the meaning of lab test results, this should help you. Check out Lab Tests Online, a website where you can quickly look up information such as the type of sample needed for a specific test, what elevated or decreased levels mean, and things that may alter the test results, such as medications.

As you are aware, specific ICD-9 Codes (International Classification of Diseases) are assigned to diagnoses and procedures that occur during a patient's hospitalization. At times, you will find the code in a medical chart without an explanation of what the code means. The American Academy of Family Physicians website has a listing of ICD-9 Codes for Family Medicine 2005-2006, and I find this helpful. This list includes the changes that took effect in 2005.

Today's entry on John's Day On Torts law blog provides great links to medical images which may be of use to you.

Many of us have worked on cases involving rotator cuff tears, or know someone who has suffered from this type of injury. Here is a great online resource, Wheeless' Textbook of Orthopaedics, which will get you started on your research and will help you understand the anatomy of the rotator cuff, findings upon examination of a patient with this type injury, surgical management of rotator cuff tears, complications of treatment, etc.

The American Stroke Association has a website that lists resources concerning care of patients who have had strokes and stroke prevention.

For example, here are the "Guidelines for the Early Management of Patients With Ischemic Stroke." And here is a clinical practice guideline for the management of aduult stroke rehabilitation care.

Use these resources to help evaluate potential cases in this field.

The American Heart Association has issued new guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. For a summary discussion of the changes, click here.

These are the five major changes in the new guidelines for CPR:

* Emphasis on, and recommendations
to improve, delivery of effective chest
compressions

* A single compression-to-ventilation
ratio for all single rescuers for all victims
(except newborns)

* Recommendation that each rescue
breath be given over 1 second and should
produce visible chest rise

* A new recommendation that single shocks,
followed by immediate CPR, be used to
attempt defibrillation for VF cardiac arrest.
Rhythm checks should be performed every
2 minutes.

* Endorsement of the 2003 ILCOR
recommendation for use of AEDs in
children 1 to 8 years old (and older); use a
child dose-reduction system if available.

(The above summary is quoted from page 3 of the Currents publication referenced immediately above.)

Find a link to the new guidelines themselves here. And here is a press release giving more details than the bullet points above.

Do you need to be able to demonstrate how a vision loss looks from the standpoint of your client? Here is a service that can help you do so.

Here is a link to an article entilted "Cervical Cancer Screening in the HPV Era: What Is the Standard of Care?"

One book we have kept in our offices for years and have referred to frequently is The Merck Manual of Diagnosis and Therapy. Did you know that you can now view this book online on the Merck & Co website? Click here to see the Merck manuals available for your online use.

You know what a podcast is. Did you know that you can get health information via podcast?

A site that has compiled a list of health-related podcasts is the Arizona Health Sciences Library. They list 9 different sites where you can download podcasts, including the New England Journal of Medicine and Access Medicine.

Thanks to Inter Alia for telling me about the site.

The American Academy of Neurology has published practice guidelines for its members. Go here to access the database of materials that they have available.

The Internet Stroke Center is a website located at the Washington University School of Medicine in St. Louis. This website is packed full of very useful information regarding strokes/ cerebrovascular accidents for patients and health care providers. A resource of the website, The Stroke Trials Directory (by Washington University, the American Stroke Association, and National Institute of Neurological Disorders and Stroke at the National Institutes of Health), provides up to date information regarding clinical trials, including ongoing trials, and stroke interventions. I think you'll want to bookmark this website because, in addition to the above, the section on Specific Stroke Scales provides numerous assessment tools for prehospital assessment, acute assessment, functional assessment, outcome assessment, and more. I hope you find this helpful.

There are a few publicly available resources on the Internet for psychiatric conditions based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ("DSM-IV"). This one at BehaveNet provides information on a number of clinical and personality disorders within DSM-IV. This one over at AllPsych Online gives a great deal of detail (including typical causes) for almost all clinical and personality disorders, and can be sorted by name, category, or DSM-IV code number.

Here is another great website to use when researching a particular disease or treatment. This family medicine resource, Family Practice Notebook, allows you to research topics related to different fields of medicine and medical conditions, provides patient education links and links for health care providers, and has a bookstore with lists of recommended medical resources.

Many hospitals and physican organizations are developing "practice guidelines" or "clinical policies" - documents which define how certain matters should be addressed by medical personnel.

Here is a link to the clinical policies issued by the American College of Emergency Physicians. The ACEP says that these documents "describe the College's policies on the clinical management of presenting symptoms, specific illnesses or injuries."

Here is a list of what they have available:

*Clinical Policy for the Initial Approach to Patients Presenting With Acute Toxic Ingestion or Dermal or Inhalation Exposure

*Practice Parameter: Neuroimaging in the Emergency Patient Presenting With Seizure (Summary Statement)

*Clinical Policy for the Initial Approach to Patients Presenting With Altered Mental Status

*Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting With Suspected Acute Myocardial Infarction or Unstable Angina

*Clinical Policy: Critical Issues for the Initial Evaluation and Management of Patients Presenting With a Chief Complaint of Nontraumatic Acute Abdominal Pain

*Clinical Policy: Critical Issues in the Evaluation and Management of Patients Presenting With Syncope

*Clinical Policy for the Management and Risk Stratification of Community-Acquired Pneumonia in Adults in the Emergency Department

*Critical Issues in the Evaluation and Management of Patients Presenting to the Emergency Department with Acute Headache

*Clinical Policy: Neuroimaging and Decisionmaking in Adult Mild Traumatic Brain Injury in the Acute Setting

*Critical Issues in the Initial Evaluation and Management of Patients Presenting to the Emergency Department in Early Pregnancy

*Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting With Suspected Pulmonary Embolism

*Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting With Suspected Lower-Extremity Deep Venous Thrombosis

*Clinical Policy for Children Younger Than Three Years Presenting to the Emergency Department With Fever

*Clinical Policy: Critical Issues in the Evaluation of Adult Patients Presenting to the Emergency Department With Acute Blunt Abdominal Trauma

*Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Seizures

*Clinical Policy: Evidence-Based Approach to Pharmacologic Agents Used in Pediatric Sedation and Analgesia in the Emergency Department

*Clinical Policy: Procedural Sedation and Analgesia in the Emergency Department

This documents are not just checklists. For example, the policy concerning assessing mild TBI in adults is 19 pages long.

These documents can be a lot of help in determining the merits of these cases.

This page has links to each state's pharmacy license information, where you can identify the owner of pharmacies operating or selling in the various states. It is a good resource for subpoena and pharamceutical request information, as well as any case involving the negligence of a pharmacist.

While doing some research yesterday, I ran across this website which is owned by Global RPh, Inc. The website is based on a hospital-wide intranet which is located at the VA Medical Center in Detroit. This website contains very useful medical calculators, medical links, and clinical guidelines. Check it out here.

One set of criteria physicians use to predict the prognosis of a patient with pancreatitis is the Ranson's Criteria. These criteria focus on patient status on admission and then again at 48 hours after admission. I found a very useful guide on the National Center for Emergency Medicine Informatics website that will actually calculate the Ranson's score and predicted mortality rate for you. Click here to go to the criteria.

When preparing Requests for Production of Documents to propound to the defendant hospital or physician, don't forget to ask for copies of all policies and procedures manual information related to your specific case topics. You may find that the defendant hospital or physician deviated from their own policies and procedures.

If you are researching an emergency medicine topic, check out the National Center for Emergency Medicine Informatics website here. This website is packed full of useful information. You can enter key words to search textbooks, Medline, and practice guidelines among other things. I find the weekly x-rays, EKGs, and photos very interesting.

I was looking at the University of Pennsylvania-School of Medicine website, and discovered a helpful page where you can enter the head circumference, the femur length, the abdominal circumference, and/or the biparietal diameter of a fetus (obtained from an ultrasound) and it will calculate the gestational age of the fetus for you based on these measurements. The website mentions it uses the fetal growth equations published in Ultrasonography in Obstetrics and Gynecology by Peter W. Callen, Second Edition. Check it out here.

Need help with EKG interpretation? Check out the popular book written by Dale Dubin, M.D. entitled Rapid Interpretation of EKG's. You can purchase the book here.

As you are probably aware, there are certain patients, including those with a history of heart valve replacement or joint replacement surgery, who require prophylactic antibiotics around the time of certain dental procedures. On the American Dental Association website, you can view guidelines regarding prophylactic antibiotic administration in these dental patients.

Women die from it, and now there is evidence that doctors do not do a very good job recognizing it. Read this Fox News article about it; it links to various sites for scientific information on the subject.

The author of a recent study says this: "Our findings suggest that ovarian cancer could be diagnosed earlier in some patients whose diagnosis currently is delayed by at least four months, because physicians order abdominal imaging or perform gastrointestinal procedures before they order a test that is more likely to diagnose ovarian cancer, such as pelvic imaging and/or CA125."

From a litigation standpoint the issue is causation: what difference would four months have made. Nevertheless, this information may help you or a member of your family get a quicker diagnosis of this life-threatening condition.

Almost 20 percent of people admitted to the MICU and CCU of an academic hospital experienced an "adverse event," and 45 percent of them were preventable, according to a new study published in the August issue of Critical Care Medicine. An article about the study reports that "over 90 percent of all incidents occurred during routine care, not on admission or during an emergency intervention."

This helps bring it home: during our lifetime each of us can expect being admitted to the ICU once.

Read the abstract here; purchase the entire article here.

Following bariatric surgery, protracted vomiting could cause thiamine (Vitamin B1) deficiency that could lead to a severe neurological disorder known as Wernicke's Encephalopathy. This condition, first described in the 1800s, is characterized by symptoms such as ataxia, ophthalmoplegia and confusion. Without prompt diagnosis of this condition along with prompt administration of intravenous thiamine, permanent brain damage or death could occur.

There are several medical journal articles out there, which address Wernicke's Encephalopathy. Here is a 2003 abstract from an article in the Obesity Surgery journal.

Another great resource regarding this topic is a book written by Maurice Victor, Raymond Adams, and George Collins entitled, The Wernicke-Korsakoff Syndrome and Related Neurologic Disorders Due to Alcoholism and Malnutrition, Second Edition.

This is good news. All of us have seen children who have suffered shoulder dystocia injuries. Now, a med mal insurer is undertaking the effort to educate some of insureds about the issue and how to avoid injuries to patients.

Included in the training are "all OB/GYNs insured by ProMutual Group in Connecticut, New Jersey and Rhode Island, as well as ProMutual Group-insured OB/GYNs and family practitioners with OB privileges in Maine, New Hampshire and Vermont." Read more about it here.

If any lawyer out there has one of these cases in the subject states please try to get a copy of the seminar materials and training films from this program. If you do obtain them, let us know. We will either post the information here or link to your website so that others may benefit from your efforts.

A recent study reported in JAMA talks about the incidence of delays in performing angioplasties and consequences of delay. The current standard provide for angioplasties within 1 and 1/2 hours after hitting the ER. Nevertheless, 40% of patients wait more than two hours. The result? The delays increase the risk of death by 7%.

Read a Seattle Times story about the study here. JAMA has an abstract of the article; you can also purchase a copy of the article at the JAMA site.

Having trouble with medical abbreviations? Check out this very helpful MediLexicon/Pharma-Lexicon website. In addition to medical and pharmaceutical abbreviations, you can find medical definitions, ICD9 Code definitions, review an extensive list of professional associations with links to their websites, etc.

Compartment Syndrome is a condition in which pressure rises within the muscles to a point of causing decreased blood flow and damage and/or death to the nerves, muscle, and tissue in the area/compartment. Compartment Syndrome can occur following surgery to an extremity, trauma to an extremity, continued swelling after the application of a cast, etc. If this condition is not promptly recognized and treated, it can lead to the need for amputation and even death in some cases.

The American Academy of Orthopaedic Surgeons has a helpful website where you can read about Compartment Syndrome and research many other orthopaedic conditions and procedures. Click here to view their information regarding Compartment Syndrome.

If you are having difficulty interpreting arterial blood gas levels when reviewing medical charts, check out this family medicine website. Information regarding ABG interpretation can be found here.

If you have ever evaluated a claim involving poor fetal outcome/fetal injury during labor and delivery, your evaluation most likely included review of the fetal heart monitor tracings. Review of the tracings gives us insight as to fetal status, including how the fetus was tolerating labor. However, reading fetal strips is an extremely difficult task for those who have not received formal training.

If you are having difficulty, a great resource is an AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) book entitled Fetal Heart Monitoring Principles & Practices. I believe this book was last updated in 2003.

The Glasgow Coma Scale is a standardized way to quickly assess a patient's level of consciousness following a brain injury. I found a helpful chart on the CDC website which explains how a Glasgow Coma Scale score is reached and what the score means.
Click here to check it out.

Most law firms that have worked on personal injury and medical malpractice cases are familiar with Wheeless' Textbook of Orthopaedics, which is a great resource. Did you know that you can now access the medical textbook online? The website, presented by the Division of Orthopaedic Surgery at Duke University Medical Center, is updated daily, and includes illustrations, etc. Click here to check it out.

Like attorneys, many health care providers form business organizations to handle their practices, whether they practice alone or with a group. How many times have you searched the Internet for the precise business name and registered agent for one of these groups? Wouldn't it be nice to have a single website with links to corporate filing information from all 50 states? Voila. The site correctly points out that the extent of information available in each state varies widely. Georgia even gives you a free search by officer's name to find every company that person serves as officer on. At a minimum, you can start your search for registered agents and official corporate names.

If you are doing research on a particular nursing home, you might want to take a look at this Medicare website. This site provides past performance (including health deficiencies) and facility information on Medicaid and Medicare certified nursing homes throughout the United States. Click here.

A useful site for researching medical journal article citations is PubMed, also known as Entrez PubMed. This site includes information contained on the MEDLINE database, and also includes citations dated prior to 1966. You can search by author, journal titles, key words, etc. There are participating journals that provide articles in full text. You may or may not have to pay a fee to access the full text.

Thanks to A.J. Levy in New Orleans for telling us about a website that permits us to view operations from our desk. The site is called OR-Live.

To look for a specific procedure go to the "archives" page, look for the medical speciality that performs the procedure and then look for the procedure.

We tried a case several years ago where we were able to use a video of a liposuction procedure on another patient to demonstrate the prep of the patient, the technique of the procedure, etc. It was also very helpful to review the video before deposing the defendant; it allowed me to get a better grasp on what the defendant actually did during the procedure.

If your expert (or the defendant) is willing to testify that the procedure as demonstrated is a true and accurate depiction of the procedure you can get the video into evidence. You might even be able to use it for standard of care testimony.

Thanks A.J. You da man!

I recently came across a website full of resources for those interested in obesity and bariatric surgery. Surgeons can register on the site and provide information regarding their practices such as what percentage of their practice is devoted to bariatric surgery. Among other things, you can calculate your body mass index, locate bariatric surgeons in your state, determine the type(s) of bariatric surgery each physician performs, and read patient testimonials regarding bariatric surgeons and hospitals. The website also contains resources for bariatric surgeons, plastic surgeons, hospital administrators, primary care physicians, and others.

Click here to view the website.

When conducting research regarding a physician's background, I always start by verifying the physician's licensure status through the medical board of the state within which the physician practices. In addition to licensure status, you can often obtain information from the state board such as the name of a physician's employer, information regarding the physician's education and training, and whether there are any documented violations. I've found the Federation of State Medical Boards website to be very helpful. It links you to the various state medical board websites and also provides addresses and contact information for the various boards.

Check out the website.

Just click on "State Medical Board Info" on the left of the page and then click on "Board Directory" for the listing.

The Internet is the great equalizer. It allows solo practioners in Burning Stump, Tennessee to have access to the same information available to the biggest law firm in the biggest bank building in the the biggest city. All you need is a computer, an Internet connection, and time.

Gloria Miccioli, a law librarian for 23 years, has written a great article that will help us get a grasp on the vast resources available to those of us who do medical research on the Web. It is filled with information about free sites and fee-based sites. If you do (or should be doing) medical research you will want to read this article.

Thanks to Gloria for sharing your knowlege with us. And thanks to Evan Schaeffer and his wonderful blog for informing me about this great article.